摘要
目的探讨口服胃造影剂B超检查鉴别胃溃疡良恶性的价值。方法.选择2017年1月至2020年1月胃溃疡患者127例,所有患者入院后均接受B超检查和胃镜检查。处理后的图片由经验丰富的医师独立阅片,观察并记录胃溃疡良恶性患者的B超和胃镜检查结果,分析B超和胃镜检查鉴别胃溃疡良恶性与病理活检结果的一致性。结果127例患者中,病理活检结果为恶性溃疡84例、良性溃疡43例。B超检查结果显示,恶性溃疡66例,良性溃疡61例。B超检查诊断胃溃疡恶性的灵敏度为0.679,特异度为0.791,准确率为0.717,Kappa=0.426;诊断胃溃疡良性灵敏度为0.791,特异度为0.679,准确率为0.717,Kappa=0.426。胃镜检查结果为恶性溃疡71例,良性溃疡56例。胃镜诊断胃溃疡恶性的灵敏度为0.750,特异度为0.814,准确率为0.772,Kappa=0.525;诊断胃潰疡良性的灵敏度为0.814,特异度为0.750,准确率为0.772,Kappa=0.525。B超联合胃镜结果为恶性溃疡76例,良性溃疡51例。B超联合胃镜诊断胃溃疡恶性的灵敏度为0.857,特异度为0.907,准确率为0.874,Kappa=0.731;诊断胃溃疡良性的灵敏度为0.907,特异度为0.857,准确率为0.874,Kappa=0.731。与单独使用B超或胃镜相比,B超联合胃镜检查胃溃疡良恶性具有更高的灵敏度、特异度,Kappa一致性更高。结论联合使用B超和胃镜检查鉴别胃溃疡良恶性,与病理活检结果一致性较高。
Objective To investigate the value of oral gastric contrast agent B ultrasound in the differential diagnosis of benign and malignant gastric ulcer.Methods 127 patients with gastric ulcer admitted to our hospital from January 2017 to January 2020 were selected as the research objects.All patients received B-ultrasound examination and gastroscopy after admission.The processed images were sent to experienced doctors to read the films independently.The results of B-ultrasound and gastroscopy in patients with benign and malignant gastric ulcer were observed and recorded,and then the consistency of the results of B-ultrasound and gastroscopy in differentiating benign and malignant gastric ulcer with pathological biopsy results was analyzed.Results Among 127 patients,84 cases were malignant ulcer and 43 cases were benign ulcer.B ultrasound examination results showed that 66 cases of malignant ulcer,61 cases of benign ulcer.According to the consistency analysis,the sensitivity,specificity,accuracy and kappa of B-ultrasound in the diagnosis of malignant gastric ulcer were 0.679,0.791,0.717,kappa=0.426;the sensitivity of benign gastric ulcer was 0.791,the specificity was 0.679,the accuracy rate was 0.717,kappa=0.426.The results of gastroscopy in differentiating benign and malignant gastric ulcer were 71 cases of malignant ulcer and 56 cases of benign ulcer.According to the consistency analysis,the sensitivity and specificity of gastroscopy in the diagnosis of malignant gastric ulcer were 0.750,0.814,0.772,kappa=0.525;the sensitivity of benign gastric ulcer was 0.814,the specificity was 0.750,the accuracy was 0.772,kappa=0.525.The results of B-ultrasound combined with gastroscopy were 76 cases of malignant ulcer and 51 cases of benign ulcer.The sensitivity of B-ultrasound combined with gastroscopy in the diagnosis of gastric ulcer malignancy was 0.857,specificity was 0.907,accuracy was 0.874,kappa=0.731,and the sensitivity of benign diagnosis of gastric ulcer was 0.907,specificity was 0.857,accuracy was 0.874,kappa=0.731.Compared with B-ultrasound or gastroscopy alone,B-ultrasound combined with gastroscopy had higher sensitivity,specificity and kappa,and higher consistency with pathological results.Conclusion It is confirmed by kappa analysis that the combined use of B-ultrasound and gastroscopy is consistent with pathological biopsy.
出处
《浙江临床医学》
2021年第3期420-422,共3页
Zhejiang Clinical Medical Journal
关键词
胃溃疡
B超
胃镜
病理活检
一致性
Gastric ulcer
B ultrasound
Gastroscope
Pathological biopsy
Consistency
